Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	114796
Country	United States

Category	Oncology
Manuscript Type	Letter to the Editor
Article Title	From inflammation to precision medicine in colon cancer: Methodological considerations and future directions
Manuscript Source	Invited Manuscript
All Author List	Arunkumar Krishnan
Funding Agency and Grant Number
Corresponding Author	Arunkumar Krishnan, Assistant Professor, MD, Senior Scientist, Department of Oncology, Atrium Health Levine Cancer, 1021 Morehead Medical Drive, Charlotte, NC 28204, United States. dr.arunkumar.krishnan@gmail.com
Key Words	Colon cancer; Elderly; Precision medicine; Systemic immune-inflammation index; Lactoferrin; Prognostic biomarkers; Survival; Methodological critique
Core Tip	A study by Zhu SS et al reported that the systemic immune-inflammation index and serum lactoferrin levels predict survival in elderly patients with colon cancer. While promising, the study was limited by a small, single-center cohort, a short follow-up period, and an incomplete adjustment for confounders. Predictive accuracy was only moderate, yet conclusions were overstated. To ensure clinical utility, future research should validate systemic immune-inflammation index and lactoferrin in larger, multicenter studies with longer follow-up, benchmark them against established prognostic indices, and incorporate molecular markers. Such efforts are crucial to establishing reliable, externally validated prognostic tools for the individualized management of older colon cancer patients.
Citation	Krishnan A. From inflammation to precision medicine in colon cancer: Methodological considerations and future directions. World J Gastrointest Surg 2025; In press

Received	2025-09-28 01:06
Peer-Review Started	2025-09-28 01:06
First Decision by Editorial Office Director	2025-10-23 07:35
Return for Revision	2025-10-23 07:35
Revised	2025-11-03 16:24
Publication Fee Transferred
Second Decision by Editor	2025-12-08 02:34
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2025-12-08 05:28
Articles in Press	2025-12-08 05:28
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
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